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Technical Guidelines for Integrated Disease Surveillance and Response in the African Region

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Technical Guidelines for Integrated Disease Surveillance and Response in the African Region Technical guidelines for integrated disease surveillance and response in the African region July 2001 World Health Organization Centers for Disease Control and Prevention Regional Office for Africa EPO-Division of International Health Division of Communicable Disease Prevention and Control NCID-Division of Bacterial and Mycotic Diseases Harare, Zimbabwe Atlanta, Georgia, USA Antoine Kaboré, MD, MPH World Health Organization Regional Headquarters for the African Region Division of Communicable Disease Prevention and Control Harare, Zimbabwe Bradley A. Perkins, MD Centers for Disease Control and Prevention National Center for Infectious Diseases Division of Bacterial and Mycotic Diseases Atlanta, Georgia Sharon McDonnell, MD, MPH Centers for Disease Control and Prevention Epidemiology Program Office Division of International Health Atlanta, Georgia This document was prepared by the WHO Regional Office for Africa (AFRO), Harare, Zimbabwe, in collaboration with the Centers for Disease Control and Prevention (CDC), Atlanta, USA, and supported by USAID. Integrated Disease Surveillance and Integrated Disease Surveillance and Response workgroup at CDC-Atlanta Response workgroup at WHO/AFRO: Bradley A. Perkins, MD Antoine Kaboré, MD, MPH Sharon McDonnell, MD, MPH Wondimagegnehu Alemu, MD, MPH Kathy Cavallaro, MS Bradford Kay, PhD John D. Leake, MD, MPH Paul S. Lusamba-dikassa, MD, PhD Peter Nsubuga, MD, MPH Mac W. Otten, Jr., MD, MPH Helen Perry, MA Louis H. Ouedraogo, MD, MPH Montse Soriano-Gabarro, MD, MSc Developed by: Mac W. Otten, Jr., MD, MPH, Medical Epidemiologist, African Regional Office (WHO) Helen Perry, MA, Educational Design Specialist, Division of International Health (CDC) Electronic Development by: Nadine Sunderland (M.Ed.) and Francois Rollin (CDC) Cover Design by: Diane Speight (B.A.) The material in this manual is in the public domain. It may be used and reprinted without permission. The source should be acknowledged. Suggested citation: World Health Organization Regional Office for Africa and the Centers for Disease Control and Prevention. Technical Guidelines for Integrated Disease Surveillance and Response in the African Region. Harare, Zimbabwe and Atlanta, Georgia, USA. July 2001: 1-229. Acknowledgments The contributions of the following individuals to the preparation and review of this document are gratefully acknowledged. CDC: WHO -HQ: WHO -AFRO: Steve Blount William Levine Ray Arthur E.A. Nyarko C. Byabamazima Cheryl Bopp Jim Mendlein Stella Chungong E. Afari J.M. Okwo-Bele Steve Cochi Eric Mintz Guenael Rodier A. Mammo Y. Kassankogno Mitch Cohen Nancy Rosenstein Cathy Roth N. Agata A. Maiga Michael Demming Peter Strebel Mike Ryan B. Koumare M. Moeti Sam Groseclose Mike St. Louis A. Yada E. Asamoah-odei Dalya Guris Robert Quick A. Ndikuyeze M. Ball Elizabeth Herman Gail Stennies L. Sarr K. Shaba Patrick Kachur Roland Sutter O. Tomori J.M. Roungou Bradford Kay Joy Wells S. Van Nieuwehhove N. Ndayimirije Jonathan King Mark White We want to thank the Government of the United Republic of Tanzania and especially Nicholas Eseko. We also want to thank the Government of Burking Faso and especially Chantal Kambiré. We gratefully acknowledge the contributions of the following organizations within WHO and CDC: Centers for Disease Control and Prevention World Health Organization (WHO) (CDC) Communicable Disease Surveillance and Response Epidemiology Program Office (CSR) Division of International Health WHO Regional Headquarters for the African Region National Center for Infectious Diseases (AFRO) Division of Bacterial and Mycotic Diseases Division of Prevention and Control of Communicable Meningitis and Special Diseases Pathogens Branch Integrated Disease Surveillance (IDS) Foodborne and Diarrhoeal Emerging and Re -Emerging Communicable Diseases Branch Disease Control (EMC) Division of Parasitic Diseases Vaccine Preventable Diseases (VPD) Division of Water-borne Infectious Tuberculosis (TUB) Diseases Other Tropical Disease (OTD) Leprosy Elimination (LEP) National Center for HIV, STD and TB Prevention Integrated Management of Childhood Division of HIV/AIDS Prevention Illnesses (IMCI) International Activities Branch Regional Program on AIDS (RPA) Division of Sexually Transmitted Disease Roll Back Malaira/Malaria Control Prevention (RBM/MAL) Surveillance and Special Studies Trypanosomiasis Control (TRY) Section Guinea worm Eradication (GWE) Global AIDS Program National Immunization Program Division of Vaccine and Preventable Disease Eradication Office of Global Health Table of contents INTRODUCTION ...........................................................................................................................1 What is integrated disease surveillance?..............................................................................2 Objectives of integrated disease surveillance ......................................................................3 How does information flow in an integrated disease surveillance system?.........................5 How can IDS contribute to epidemic preparedness? ...........................................................6 How are surveillance functions described in these guidelines?...........................................6 How can districts strengthen surveillance and response? ....................................................8 What is contained in these guidelines? ..............................................................................12 Who are the guidelines for? ...............................................................................................12 Which diseases are to be included .....................................................................................13 How does WHO/AFRO support efforts to strengthen disease surveillance? ....................14 Annex 1 Using assessment results to improve surveillance and response at the district level…………………………………………………………………………..15 SECTION 1.0 IDENTIFY CASES OF PRIORITY DISEASES AND CONDITIONS .........19 1.1 Use standard case definitions .................................................................................22 1.1.1 Review case definitions used by health facilities in the district ..............23 1.1.2 Distribute simplified case definitions to the community...........................23 1.2 Improve district procedures for surveillance and response....................................24 1.2.1 Update the description of the catchment area ............................................24 1.2.2 Update the list of reporting sites in the district ..........................................24 1.3 Define laboratories for confirming suspected outbreaks .......................................25 1.3.1 Establish communication with the designated laboratories .......................25 1.3.2 Identify a district laboratory focal point ....................................................26 ANNEXES TO SECTION 1..............................................................................................27 Annex 2 WHO/AFRO recommended case definitions for reporting suspected priority diseases or conditions from the health facility to the district ……………………………………………………………………...29 Annex 3 Simplified messages for use in community surveillance..................32 Annex 4 Recommended laboratory tests to confirm priority diseases and conditions..........................................................................................33 Annex 5 List of laboratories for confirming priority diseases and conditions 40 Annex 6 List of district reporting sites ............................................................41 SECTION 2.0 REPORT PRIORITY DISEASES AND CONDITIONS................................43 2.1 Know how often to report priority diseases and conditions ..................................45 2.2 Record information in clinic registers or patient charts.........................................47 2.3 Use standard methods for reporting priority diseases............................................48 2.3.1 Report immediately reportable diseases or unusual events promptly........49 2.3.2 Report case-based information on a form..................................................49 2.3.3 Report summary data routinely..................................................................50 2.4 Improve routine reporting practices.......................................................................51 2.4.1 Review the flow of information in the health facility................................51 2.4.2 Submit zero-reporting when no cases of immediately reportable diseases are diagnosed..............................................................................................52 2.4.3 Use line lists and summary reporting during outbreaks.............................52 ANNEXES TO SECTION 2..............................................................................................53 Annex 7 Maintaining clinic registers for recording priority diseases and conditions .........................................................................................55 Annex 8 Case-based surveillance reporting form............................................56 Annex 9 Line list for reporting case-based information when several cases occur during a short period ...............................................................62 Annex 10 Monthly surveillance summary report form for out-patient cases and in-patient cases and deaths (health facility to district) .....................64 Annex 11 Monthly surveillance summary report form for out-patient cases
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